The Wisconsin Department of Health Services (DHS) is announcing new accountability measures aimed at preventing fraud and improving health outcomes for child care coordination, a Medicaid post-birth benefit created under state law to address health disparities in southeastern Wisconsin. Child care coordination and prenatal care coordination (PNCC) provide prenatal and post-birth services to support vulnerable families at high risk of a negative health outcome—a critical program designed to improve infant and maternal health and reduce infant and maternal mortality.

The sweeping effort comes as the DHS Office of the Inspector General (OIG) has reviewed and investigated multiple instances of suspected fraud of child care coordination services by providers and has taken action to implement provider enrollment terminations and suspensions. OIG has issued referrals to the Wisconsin Department of Justice Medicaid Fraud Control Unit on 20 different Medicaid providers engaging in suspected fraudulent activity that resulted in the provider being paid for false claims.

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